- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $4,897.79 / $14,125.38
| Facility | | $1,023.29 | $4,897.79 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $25,118.86 / $31,622.78
| Facility | | $7,413.10 | $25,118.86 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $707.95 / $794.33
| Facility | | $676.08 | $707.95 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,122.02 / $1,548.82
| Facility | | $707.95 | $1,122.02 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $11,220.18 / $17,378.01
| Facility | | $4,897.79 | $11,220.18 | $17,378.01 |